File:Operative gynecology - (1906) (14781231384).jpg

Identifier: operativegynecol001kell (find matches)
Title: Operative gynecology :
Year: 1906 (1900s)
Authors: Kelly, Howard A. (Howard Atwood), 1858-1943
Subjects: Gynecology Gynecology Gynecologic Surgical Procedures
Publisher: New York and London : D. Appleton and company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
examining thepatient, who was twenty-eight years old, he found a large stone 2 by 2-J by 1;inches in diameter in the bladder; she would not allow any cutting operationto be done, so he caught the stone with a pair of forceps introduced throughthe urethra, and deliveredit slowly by traction. Theexternal meatus was themost resistant portion, buthe succeeded in working itthrough in about three-quarters of an hour, bypressing back the tissuesover the stone much as anobstetrician may try to helpthe perineum back over theadvancing head of the child.The stone was rough on oneside and tore the mucousmembrane of the canal con-siderably ; this produced asharp venous hemorrhage ofshort duration. In spite ofthis enormous dilatation,she suffered no serious in-convenience, although un-able to hold her water aslong as before. 2. The vaginal inci-sion is to be preferred for stones which are so large that they can notsafely be removed through the urethra, and is adapted to all but the largestcalculi.
Text Appearing After Image:
Fig. 245.—Removal of a Calculus through a Vaginal In-cision MADE FROM THE CERVIX UTERI TO THE TRIGONUM Vessels. The method of making the incision is described on p. 412.(Sanger, March 20, 1899.) Natural size. 412 AFFECTIONS OF THE URETHRA AND BLADDER. The operation is best conducted with the patient lying in the left semi-prone position, with the posterior vaginal wall well retracted, so as to exposeclearly the entire extent of the anterior wall from cervix to urethra. A bluntinstrument like a male sound is now introduced through the urethra into thebladder, and the vaginal wall is pushed forward in the median line and cutthrough, opening the. bladder; the incision is now extended by drawing apartthe edees of the wound and cutting; back toward the cervix and forward towardthe neck of the bladder until it is large enough to permit the introduction of theblades of a pair of stone forceps, which are used to grasp the stone by its small-est diameter and draw it out through the wound end

Note About Images